Given the primary role of states in financing, regulation and quality assurance for mental health care, their administrators and policymakers rely increasingly on administrative data bases for monitoring treatment encounters, evaluating programs and assessing whether care patterns are consistent with unfolding priorities. With limited resources and demands for urgent and immediate responses, states typically have difficulty conducting extensive analyses and use readily available data. Compromises are made in methodology necessitated by the need for ready answers. The specific aims of this research were to merge Medicaid claims data on mental health services utilization with data on services use in state-operated mental institutions and outpatient programs over a five year period to create a comprehensive, integrative database. Analyses examined linkage rates to outpatient care after a hospital discharge and rehospitalization rates using Medicaid data alone and compared them with the rates obtained with the merged database. Logistic regression models and survival analyses compared the results of the predictors of linkage and rehospitalization across the two databases. The analyses evaluate the extent to which policy conclusions might have been different had Medicaid files been used alone in contrast to the comprehensive database. The merged data enrich our understanding of the interconnections between Medicaid reimbursed services and other non-Medicaid, publicly supported services. To understand the various risk factors determining patient flow and continuity and to provide benchmarks against which policymakers can evaluate the impact of managed care require the creation of databases that previously have been difficult to develop.
Learning Objectives: 1. Describe the policy and conceptual significance of using a comprehensive and integrative data base for measuring the use of mental health services by the most disadvantaged and disabled mentally ill. 2. Recognize the interconnections between Medicaid reimbursed services and other non-Medicaid, publicly financed services. 3. Identify the three major limitations of using Medicaid claims data alone in measuring mental health services utilization.
Keywords: Medicaid, Mental Health System
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.